Prosthesis and methods for total knee arthroplasty

• US 6,342,075 B1
• Filed: 02/18/2000
• Issued: 01/29/2002
• Est. Priority Date: 02/18/2000
• Status: Expired due to Fees

• Current Assignee: Macarthur A. Creig
• Original Assignee: Macarthur A. Creig
• Inventors: MacArthur, A. Creig
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US09/506,821
• Time in Patent Office: 711 Days
• Field of Search: 623/20.15, 623/20.14, 623/20.11, 623/20.23, 623/20.27, 623/20.29, 623/20.31, 623/18.11, 623/19.11
• US Class Current: 623/20.14
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30113 circular
• CPC Class Codes: A61F 2002/30125 elliptical or oval
• CPC Class Codes: A61F 2002/30143 hexagonal
• CPC Class Codes: A61F 2002/30146 octagonal
• CPC Class Codes: A61F 2002/30154 square
• CPC Class Codes: A61F 2002/30156 triangular
• CPC Class Codes: A61F 2002/30158 trapezoidal
• CPC Class Codes: A61F 2002/30172 T-shaped
• CPC Class Codes: A61F 2002/30233 Stepped cylinders, i.e. having discrete diameter changes
• CPC Class Codes: A61F 2002/3028 polyhedral different from parallelepipedal and pyramidal
• CPC Class Codes: A61F 2002/30299 umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30759 Mosaicplasty, i.e. using a plurality of individual cartilage plugs for filling a substantial cartilage defect
• CPC Class Codes: A61F 2002/30878 with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30892 parallel
• CPC Class Codes: A61F 2002/30922 : Hardened surfaces
• CPC Class Codes: A61F 2002/3895 : unicompartimental
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0021 : square
• CPC Class Codes: A61F 2230/0023 : triangular
• CPC Class Codes: A61F 2230/0026 : trapezoidal
• CPC Class Codes: A61F 2230/0052 : T-shaped
• CPC Class Codes: A61F 2230/0063 : Three-dimensional shapes
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0093 : Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures
• CPC Class Codes: A61F 2310/0058 : Coating made of diamond or of diamond-like carbon DLC

Abstract

A knee joint prosthesis, comprising at least one femoral component and at least one tibial component. The femoral component having a first portion adapted for fixable attachment to a distal end of a femur and a second portion formed with a bearing surface. The femoral component is sized so as to permit attachment to the femur of a patient without severing at least one the cruciate ligaments. The tibial component has a first surface that is adapted to cooperate with a patient'"'"'s tibia, while a second surface of the tibial component is adapted to cooperate with the femoral component. The tibial component is sized so as to permit attachment to the patient'"'"'s tibia without severing at least one of the cruciate ligaments.

Claims

1. A prosthetic knee component for attachment to a surface of a knee, comprising:

(a) a first portion having a generally spheroidal bearing surface and a superior surface; and

(b) a second portion fixably attached to said first portion opposite to said spheroidal bearing surface, said second portion having a first cross-sectional dimension and being adapted for fixable attachment to the surface the knee to enable a portion of said generally spheroidal bearing surface to extend from the surface of the knee; and

(c) a transition portion intermediate of said first portion and said second portion and extending from said superior surface of said first portion, said transition portion having a second cross-sectional dimension larger than the first cross-sectional dimension.

2. The prosthesis as recited in claim 1, wherein said first portion has a generally circular cross-section.

3. The prosthesis as recited in claim 1, wherein said first portion is adapted to reduce friction.

4. The prosthesis as recited in claim 1, wherein said second portion includes attachment means for assisting the attachment of the prosthetic component to the limb of the patient.

5. The prosthesis as recited in claim 4, wherein said attachment means comprises a plurality of raised portions extending from said second portion.

6. The prosthesis as recited in claim 1, wherein said second portion is adapted with at least one thread that substantially encompasses said second portion.

7. A prosthetic knee assembly adapted for attachment to the surfaces of a knee, comprising, a plurality of femoral components adapted for fixable attachment to the surface of the knee, each femoral component of the plurality of femoral components having a first portion with a generally spheroidal bearing surface, a transition portion extending from said first portion and having a smaller diameter than the first portion, and a second portion fixably attached to said transition portion, said transition portion and said second portion being adapted for fixable attachment to the femoral surface of the knee such that a portion of said bearing surface extends from the condyle of the knee.

8. The prosthesis recited in claim 7, wherein the surface includes both a medial condyle and a lateral condyle.

9. The prosthesis as recited in claim 7, wherein said first portion has a generally rectangular cross-section.

10. The prosthesis as recited in claim 7, wherein said second portion includes attachment means for assisting the attachment of the prosthetic component to the limb of the patient.

11. The prosthesis as recited in claim 10, wherein said attachment means comprises a plurality of raised portions extending from said second portion.

12. The prosthesis as recited in claim 10, wherein said second portion is adapted with at least one thread that substantially encompasses said second portion.

13. A prosthetic knee component for attachment to a condyle of a knee, comprising:

(a) a generally spheriodal first portion adapted as a bearing surface, said first portion having a superior surface generally opposite to and connected to said bearing surface and having a first cross-sectional dimension;

(b) a second portion generally perpendicular to said superior surface and extending from said superior surface, said second portion having a second cross-sectional dimension smaller than said first-cross-sectional dimension; and

(c) a third portion extending from said second portion and having a smaller cross-sectional dimension than said second cross-sectional dimension, said second and third portions being adapted for fixable attachment to said condyle of said knee without severing of both cruciate ligaments of said knee.

14. The prosthesis as recited in claim 13, wherein the prosthetic knee component is shaped to prevent detachment from the knee.

15. The prosthesis as recited in claim 13, wherein said bearing surface is polished to reduce friction effects.

16. The prosthesis as recited in claim 13, wherein said bearing surface has a curved profile.

17. The prosthesis as recited in claim 13, wherein the prosthetic knee component includes attachment means for assisting the attachment of the prosthetic knee component to the knee.

18. The prosthesis as recited in claim 17, wherein said attachment means comprises at least one stem extending from at least one of said second portion and said third portion of the prosthetic knee component.

20. A prosthesis as recited in claim 18, wherein attachment of said femoral component is performed through an incision.

21. A prosthesis as recited in claim 18, wherein said first portion of said femoral component includes a stem for insertion into said femur.

22. A prosthesis as recited in claim 18, wherein said second portion of said femoral component is spheroidal in configuration.

23. A prosthesis as recited in claim 18, wherein said tibial component has a generally rectangular form, wherein said first surface and second surface are substantially planar.

24. A prosthesis as recited in claims 18, wherein said tibial component is formed from two tibial component portions.

25. A prosthesis as recited in claim 18, wherein said bearing surface is covered with a friction reducing coating.

19. A knee joint prosthesis for attachment to a femur and a tibia of a patient during unicompartmental or total knee replacement, the prosthesis comprising:

(a) a plurality of femoral components configured to be attached to the femur, each of the plurality of femoral components having a first portion adapted for fixable attachment to the femur and a second portion formed with a spheriodal bearing surface, said femoral components being configured so as to permit attachment to the femur by an arthroscopic surgical procedure without severing both of the cruciate ligaments; and

(b) at least one tibial component having a first surface adapted to cooperate with the tibia and a second surface adapted to cooperate with at least two of said plurality of femoral components affixed to the femur disposed opposite the at least one tibial component affixed to the tibia, said tibial component being configured so as to permit attachment to the tibia by an arthroscopic surgical procedure and without severing both of the cruciate ligaments.

26. A total knee joint prosthesis, comprising:

(a) a femoral component adapted for attachment to a femur of a patient by an arthroscopic procedure while retaining at least one cruciate ligament, said femoral component having a generally spheroidal form with a lower surface portion and a superior surface cooperating with said lower surface portion, while including a stem extending therefrom; and

(b) a tibial component having a first surface configured to aid in attachment of said tibial component to a tibia by an arthroscopic procedure and a second surface adapted to cooperate with said lower surface portion of said femoral component.

27. A prosthesis as recited in claim 26, wherein said superior surface includes a step configuration.

28. A prosthesis as recited in claim 27, wherein said step configuration of said superior surface includes at least one transition portion.

29. A prosthesis as recited in claim 26, wherein said stem is generally perpendicular to the superior surface.

30. A prosthesis as recited in claim 29 wherein said stem is formed with attachment means for assisting the attachment of said femoral component to the femur.

31. A prosthesis as recited in claim 30, wherein said attachment means includes a plurality of raised portions.

32. A prosthesis as recited in claim 26, wherein said first surface includes a stem extending therefrom.

33. A prosthesis as recited in claim 26, wherein said second surface has a curved profile to cooperate with said lower surface portion.

34. A prosthesis as recited in claim 26, wherein said second surface is angularly orientated relative to said first surface.

35. A method of repairing a patients damaged knee, specifically portions of a femoral condyle and a tibial plateau, while preserving both cruciate ligaments, comprising the steps of:

(a) obtaining a prosthetic knee adapted for fixable attachment to a surface of the patients knee and being capable of separating the femoral and tibial surfaces;

(b) preparing the patients knee for implantation of the prosthetic knee by way of an arthroscopic surgical procedure that uses at least two small portals formed in tissues surrounding the femoral condyle and the tibial plateau; and

(c) implanting the prosthetic knee into at least one of the femoral condyle and the tibial plateau by way of said at least two portals thereby separating portions of the femoral condyle and the tibial plateau.

36. The method as recited in claim 35, wherein the knee joint prosthesis comprises a femoral component having a bearing surface and a tibial component having an upper surface adapted to cooperate with said bearing surface.

37. The method as recited in claim 36, wherein said femoral component has a first portion adapted for fixable attachment to a femoral surface and a second portion formed with the bearing surface.

38. The method as recited in claim 37, wherein said tibial component has a first surface adapted to cooperate with the tibial plateau and a second surface adapted to cooperate with said femoral component.

39. The method as recited in claim 38, wherein the step of preparing the patients knee comprises:

(a) creating said at least two portals in the knee to allow access to the knee joint; and

(b) positioning at least one surgical apparatus through at least one of said at least two portals.

40. The method as recited in claim 39, wherein the step of implantation comprises:

(a) identifying the motion of the knee joint;

(b) verifying the implantation location of the knee joint prosthesis based on the motion of the knee joint;

(c) forming one or more anchoring holes to accommodate the knee joint prosthesis; and

(d) fixing the knee joint prosthesis within the knee joint by way of the anchoring hole.

41. The method as recited in claim 40, wherein the step of forming one or more anchoring holes comprises drilling one or more anchoring holes in the femoral condyle.

42. The method as recited in claim 41, further including the step of forming a channel in the tibial plateau, the channel being adapted to receive said tibial component.

43. The method as recited in claim 42, wherein the fixing step comprises positioning the stem of the femoral component within one of said one or more anchoring holes and fixing in place through attachment means for assisting in attachment of the femoral component to the femoral condyle.

44. The method as recited in claim 43, wherein the attachment means comprises the combination of a plurality of raised portions with a materials selected from the group consisting of cements, porous bone ingrowth techniques, and polymethyl methacrylate.

45. A The method as recited in claim 44, wherein the attachment means comprises polymethyl methacrylate.

46. A method of repairing a patients damaged knee, comprising the steps of:

(a) obtaining a femoral component comprising a first portion adapted for fixable attachment to a distal end of a patients femur and a second portion adapted with a bearing surface;

(b) removing a portion of a patients femur through one or more portals, associated with an arthroscopic surgical procedure, to create one or more anchoring holes while preserving substantially all other portions of said patients femur and both cruciate ligaments;

(c) fixing said femoral component within one of said one or more anchoring holes such that a portion of said bearing surface extends above said distal end of said femur;

(d) obtaining a tibial component having a first surface adapted to cooperate with a surface of a tibia and a second surface adapted to cooperate with said bearing surface of said femoral component;

(e) removing a portion of said tibia to create a channel to receive said tibial component; and

(f) fixing said tibial component within said channel such that said second surface cooperates with said bearing surface to substantially separate said distal end of said femur from said tibia.

47. The method as recited in claim 46, wherein said bearing surface is polished to reduce frictional forces.

48. The method as recited in claim 47, wherein the removing step comprises drilling said anchoring holes in said patients femur with a surgical drill.

49. The method as recited in claim 48, wherein said step of fixing the femoral component comprises cementing said first portion of said femoral component into one of said one or more anchoring holes.

50. The method as recited in claim 49, wherein the step of fixing femoral component comprises attaching said first portion by way of polymethyl methacrylate.

51. The method as recited in claim 50, wherein the removing step comprising sawing and chiselling portion of said patients tibia.

52. The method as recited in claim 51, wherein the step of fixing tibial component comprises attaching said surface to said tibia by way of polymethyl methacrylate.